Katsiaryna Laryionava1,2, Eva Caroline Winkler3. 1. Department of Medical Oncology, National Center for Tumor Diseases (NCT), Programme for Ethics and Patient-Oriented Care in Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany. katsiaryna.laryionava@med.uni-heidelberg.de. 2. Institute for History and Ethics of Medicine, Centre for Health Sciences, Martin Luther University Halle-Wittenberg (Saale), Halle (Saale), Germany. katsiaryna.laryionava@med.uni-heidelberg.de. 3. Department of Medical Oncology, National Center for Tumor Diseases (NCT), Programme for Ethics and Patient-Oriented Care in Oncology, Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany.
Abstract
PURPOSE OF REVIEW: The family plays a significant role in end-of-life care and decision-making with advanced cancer patients. This non-systematic review aims to summarize the family role and possible emerging conflicts and problems related to family involvement in decisions with advanced cancer patients. RECENT FINDINGS: Four important domains were identified: (1) discordance between patients and caregivers' understanding of prognosis and goals of care; (2) internal family conflicts; (3) cultural differences regarding the role of the family in end-of life decision-making; (4) the burden on caregivers through caring for cancer patients. Based on the findings, we formulated some implications to consider for clinical practice. We suggest to involve the family in decision-making, to ascertain patients' wish for family involvement and if necessary, taking a mediator role between patients and their caregivers; to be aware of "invisible" family influence on patients' decisions; to assess systematically family burden and needs; to provide timely information, psychological support interventions and palliative care.
PURPOSE OF REVIEW: The family plays a significant role in end-of-life care and decision-making with advanced cancer patients. This non-systematic review aims to summarize the family role and possible emerging conflicts and problems related to family involvement in decisions with advanced cancer patients. RECENT FINDINGS: Four important domains were identified: (1) discordance between patients and caregivers' understanding of prognosis and goals of care; (2) internal family conflicts; (3) cultural differences regarding the role of the family in end-of life decision-making; (4) the burden on caregivers through caring for cancer patients. Based on the findings, we formulated some implications to consider for clinical practice. We suggest to involve the family in decision-making, to ascertain patients' wish for family involvement and if necessary, taking a mediator role between patients and their caregivers; to be aware of "invisible" family influence on patients' decisions; to assess systematically family burden and needs; to provide timely information, psychological support interventions and palliative care.
Authors: J Nicholas Dionne-Odom; Andres Azuero; Kathleen D Lyons; Jay G Hull; Tor Tosteson; Zhigang Li; Zhongze Li; Jennifer Frost; Konstantin H Dragnev; Imatullah Akyar; Mark T Hegel; Marie A Bakitas Journal: J Clin Oncol Date: 2015-03-23 Impact factor: 44.544
Authors: Michelle DiGiacomo; Yutaka Hatano; Jane Phillips; Joanne Lewis; Amy P Abernethy; David C Currow Journal: Palliat Med Date: 2016-08-08 Impact factor: 4.762